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Male Factor Infertility

Sperm health is declining in the Western world at worrying rates, with sperm counts having dropped around 50% in the last 40 years. There is now some limited data to show that this not just be restricted to the West, and may in fact be more widespread.

Research shows that between 1973 to 2018, the levels of decline in the West were 1.2% annually, but since 2000 those figures have accelerated to 2.5% every year. 

Currently 1 in 7 couples experience infertility, and 30% of those are solely male factor related (and another 30% down to a combination of both male and female factor). As such, male factor infertility is now the primary cause of couples seeking IVF treatment. Deteriorating semen quality and male reproductive health is beginning to escalate into a general fertility crisis. 

Why is this happening? 

Recent research (Kortenkamp et al, 2002) suggests the answer may be complex, with lifestyle playing a part (including recreational drug use or smoking during pregnancy being possible components), but also that exposure to chemicals looks to be contributing factor. Perry (2023) suggests use of pesticides is also playing a role in this decline, while Osadchiv et al (2024) argue that the semen microbiome (and in particular high levels of the bacteria lactobacillus iners) may be affecting semen parameters.

So what can be done?

Some researchers have suggested that reducing unnecessary exposure to certain environmental chemicals may be beneficial for overall reproductive health. Other suggestions from recent studies include thorough washing of vegetables, avoiding alcohol and smoking, exercising regularly, minimising stress, avoiding processed foods, and eating a diet rich in antioxidants, probiotics and fibre.

What are the common issues that men face with fertility?

  • Suboptimal semen analysis (ie motility, morphology 
  • varicocele (a pooling of blood in the veins around the testicles, leads to DNA fragmentation) – 10-15% of men affected. In couples experiencing infertility this goes up to 40%
  • Azoospermia (no sperm in the ejaculate -affects 1 in 100 men). Can be obstructive or non obstructive)- referral to urologist needed, as this can be worked on 
  • Hormonal imbalance 
  • Infection
  • DNA fragmentation – can be a cause of embryonic development failure and recurrent miscarriage
  • oxidative stress – usually caused by lifestyle / infection – needs to be within a certain range to help with hormone balance
  • Testicular trauma
  • History of undescended testicles
  • History of mumps or glandular fever

How can working with a practitioner help?

  • knowledge and roadmapping of testing and available options, referrals etc 
  • Working with diet, lifestyle and supplementation, all of which may play a role in supporting reproductive health
  • Emotional support 
  • Stress management 

When I work with couples experiencing infertility, I always look at both sides of the equation – both male and female. Get in touch to find out more.

Burnout

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Burnout is a chronic state of stress which leads to physical, emotional and mental exhaustion.

 

Cases of burnout are becoming increasingly common due to societal and work pressures and in societies where there are fewer boundaries – in today’s fast paced world we’re often expected to be constantly productive and always available. 

It can (and does!) happen to anyone – not just the stereotypical city worker. In fact, it’s more common amongst younger people and women, as well as those in caring professils as people tend to over-give, to the point of exhausting themselves.

It can be a very gradual process, starting with enthusiasm which eventually leads to exhaustion, often over several years. People experiencing it often don’t realise that they’re experiencing burn out initially and sometimes there’s a sense of shame that surrounds it, or a feeling of failure.

 

It can seem hard to know where to turn if you’re experiencing burn out, or what to do.  Most advice seems to be centred around individual failings…i.e. to exercise more, holiday more, ‘do’ more, ‘care’ less – often people are in fight and flight so this advice isn’t always very helpful.

 

Signs of burnout:

  • Environmental triggers – usually something has changed in environment, which means that more energy is being expended, or something  introduced with more demands (new job, relationship issues, extended working hours, difficult project etc) so our levels of stress increase
  • In addition to this, often something isn’t working in that change of environment – not enough time, increased responsibility, not feeling valued, lack of resources etc. Personal values are compromised and there is usually a feeling of a lack of support / lack of control 
  • Then follows adaptive behaviour – compromising boundaries or taking less responsibility for self care / reducing non-essentials in life (resting, having fun etc)
  • Typically we try to exert more energy to combat this, we try harder, or work longer, telling ourselves if I try harder, do more, or give more, things will get better. Or we feel powerless to change, and think we have to put up with things
  • In Polyvagal theory, when people are burning out they are in fight and flight and then dorsal vagal (feeling emotionally unsafe, hyper vigilant)

Burnout has a profound affect on the body and mind and can include the following signs and symptoms:

  • Headaches
  • Fatigue
  • Digestion issues 
  • Brainfog 
  • Nausea
  • Feelings of overwhelm or helplessness 
  • Procrastination 
  • Irritability 
  • Changes in appetite and sleep

Sometimes we try to deal with strong feelings but addictive behaviours, such as numbing with alcohol, excessive social media use, over exercising, recreational drugs etc 

The following can be helpful in addressing burnout: 

  • Acknowledging whats happening 
  • Frequent checks in with the body
  • Visiting a talking therapist and / or bodyworker 
  • Getting support on the situation that’s changed
  • Seeking help from friends and family
  • Not judging yourself 

How acupuncture can help:

Many  people choose acupuncture as part of their approach to managing stress, supporting emotional wellbeing and encouraging relaxation.

Research has explored whether acupuncture may: 

  • Influence areas of the brain associated with stress regulation and relaxation (Hui 2010)
  • Affect neurotransmitters and hormones involved in mood regulation, including serotonin, noradrenaline, dopamine and GABA (Lee 2009; Samuels 2008; Zhou 2008; Yuan 2007
  • Influence activity within the autonomic nervous system, including pathways associated with relaxation and recovery (Arranz 2007)
  • Affect inflammatory markers associated with stress response (Arranz 2007)
  • Influence behavioural and physiological responses to stress (Kim 2009).
  • Reverse pathological changes in levels of inflammatory cytokines that are associated with anxiety (Arranz 2007)
  • Increase cerebral blood flow (Yan 2010) reducing sympathetic nervous system activity, hence increasing relaxation (Lee 2009a)
  • Increase circulation to relax tight muscles and reduces joint stiffness (Komori 2009)
  • Reduce inflammation, by promoting release of vascular and immunomodulatory factors (Kavoussi 2007, Zijlstra 2003).
  • Reduce insomnia through increasing nocturnal endogenous melatonin secretion (Spence 2004).